How to Handle Night Shift Challenges as a CNA

CNAs have to face several challenges in night shift in any healthcare facilities is quite challenging. It is like working against the routine procedure. But once you are accustomed to the routine, the shift will become enjoyable. Here are the tips to fight fatigue and other challenges.

Night shift is the most challenging time to work be it any profession. Since we are going against the routine procedure, our body is not made for, experiencing certain health problems is natural once you start working in the night shift. As we are working during the time when our body and mind need the rest, we are doing the opposite. Even nursing aides working in healthcare sectors are not untouched with the problem faced while working in odd shifts. They have to deal with several types of problems besides fatigue. As you have joined the nursing profession, you must first know the following challenges while working in the night shift.

Most of the problems in the nursing field is due to the staff shortage across the United States. That is why each nurse aide has to cater her services to minimum ten to fifteen patients. On the top of it, the situation each patient in the facility is experiencing is different. Some might be having a problem associated with dementia,while others may need assistance in incontinence. Then there may be some who have the habit of taking a shower before going to the bed.Handling people with such different types of issues all alone in a shift is a tedious task.

Though death has no particular time or appointment, mostly, it occurs during the time when the rest of the world is sleeping. Death at night shift in various healthcare facilities has been confirmed through a survey. Night shift CNAs are the first to know that the patient has expired or is about to give up his or her fight against the death. When somebody dies, nurse aides have to remove all the equipments used in keeping the deceased alive. It is their duty to perform the after-death care and send the body to the morgue and inform the relatives.

Another challenge is documenting the stock of supplies and sanitizing equipments. Nursing aides have to clean the wheelchairs, bed linens,help patients put on new clothing, and bathe them. Further, it is also necessary that the patient does not sleep in the same position to develop bedsores. Nursing aides have to change the position in the bed without disturbing or breaking patient's sleep.

Here are the tips to handle these night shift challenges

The staffing problem can be managed if you are in good terms with other CNAs. As soon as you are debriefed by the outgoing nurse aide,try to sort out tasks starting with the most urgent. Do not hesitate to ask for assistance if the you need it. Since nursing patients is a team work, your colleagues will offer help if they are less burdened than you. If you are showing your concern for the comfort, safety and faster recovery of patients, getting help is easier.

Since you have done your best to extend the lives of clients under your care, you should not be affected emotionally when the inevitable happens. When a patient dies, honor her or him by performing the after-death care. You may also need to console the relatives, and help them embrace the truth with a strong heart. Instead of lamenting over the fact, and take it to the heart, try communicating with co-workers. Get charged and make a promise to yourself that you will not allow any more death during your shift. This will motivate you to keep going.

Keep the cleaning and documenting work when you have completed with activities like bathing, feeding, changing the soiled linens and patients' uniforms. Try to use the maximum of the shift time by organizing the equipments to be cleaned at one place. When patients are fast asleep, you will get enough time to handle these chores.

These are the challenges and tips to handle them while working in the night shift. If you manage your time and have planned properly, you can also have your breaks and chat with your co-workers in the spare time. No doubt, you will have problems working in night shift during the first few months. However, once you are accustomed to the routine, the shift will become enjoyable.

Kacie is in nursing assistant profession for the last three years. She loves her job the same way like a child loves ice-creams. She is sincere, matured and a thorough professional who takes pride in what she is doing. She is an ardent reader full of passion to share her feelings and experience with different communities. She is providing lots of resourceful and interesting information to ecnaclasses.com just to help budding nursing aides.

Nursing aids are a vital part of the Healthcare team and face the same challenges as all healthcare workers that work nights. Man is not a nocturnal animal and it does effect the circadian rhythm.

There might a lack of bedside workers.....but it has nothing to do with a shortage of workers......it has everything to do with hospitals/facilities not hiring enough staff and pointing the finger at this imaginary "shortage" as an excuse so they do not appear greedy and uncaring.

Since you have done your best to extend the lives of clients under your care, you should not be affected emotionally when the inevitable happens. When a patient dies, honor her or him by performing the after-death care. You may also need to console the relatives, and help them embrace the truth with a strong heart. Instead of lamenting over the fact, and take it to the heart, try communicating with co-workers. Get charged and make a promise to yourself that you will not allow any more death during your shift. This will motivate you to keep going.

You offer some very good advice, but I disagree with the paragraph above. I don't think you should be devastated by a patient's death, but it is alright to be emotionally affected. We often care for patients many times during their last years and get to know them and care for them on a personal level as well as a professional level. We get to know them well...and they know us as well. They ask about our families and share in the pride we have for our children. I see no need to promise myself not to allow any more death on my shift. I consider it an honor to care for someone in their last hours and to make that transition whatever they need it to be. What greater service can we provide than to ensure they die with dignity, comfort, and a sense of peace?

May 16, '13

Joined: Feb '13; Posts: 158; Likes: 57

As a CNA, I've had to give post-mortem care to several people. Of course it was emotionally hard to do, but I did hold it together. It's been hard to see the families when they're sad, but I try to be strong for them.

Since you have done your best to extend the lives of clients under your care, you should not be affected emotionally when the inevitable happens. When a patient dies, honor her or him by performing the after-death care. You may also need to console the relatives, and help them embrace the truth with a strong heart. Instead of lamenting over the fact, and take it to the heart, try communicating with co-workers. Get charged and make a promise to yourself that you will not allow any more death during your shift. This will motivate you to keep going.

This sentiment is dangerous and detrimental to care. First, as many have pointed out, it is not unnatural or wrong in any way to feel upset when a patient dies. Nurses and nursing staff, especially on my Onc ward, got to know patients and their families very well, many times over the course of years on the job. To try to internalize the passing of a patient or deflect your feelings by talking with people is unhealthy. Notice I said deflect--there is a difference between trying to avoid your feelings by talking versus trying to process them.

Unless you're the grim reaper, you have very little say in whether or not you "allow death" on your shift. We can do CPR and take ACLS measures to try to prolong life, but ultimately, it isn't up to us.

Also, it is expected that some patients (those who are comfort care & DNR) are going to die in the hospital. Your job then is to help them die. To go into a shift with the mentality that you're somehow fighting death in these cases is wrong for everyone.

The ultimate way I have honored many of my patients is by helping them die comfortably and in minimal pain. Was it difficult? Absolutely. Worthwhile? Wouldn't have changed it for the world.

Though death has no particular time or appointment, mostly, it occurs during the time when the rest of the world is sleeping. Death at night shift in various healthcare facilities has been confirmed through a survey. Night shift CNAs are the first to know that the patient has expired or is about to give up his or her fight against the death. When somebody dies, nurse aides have to remove all the equipments used in keeping the deceased alive. It is their duty to perform the after-death care and send the body to the morgue and inform the relatives.

I cannot pronounce or call a time of death of a patient, and it is not my place to communicate to family that a patient has died. It's outside of my scope and could get me fired.

Another challenge is documenting the stock of supplies and sanitizing equipments. Nursing aides have to clean the wheelchairs, bed linens,help patients put on new clothing, and bathe them. Further, it is also necessary that the patient does not sleep in the same position to develop bedsores. Nursing aides have to change the position in the bed without disturbing or breaking patient's sleep.

Some well staffed facilities do have night CNA's do some chores that other shift CNA's don't do. They tried to pull this at my previous facility and it didn't go too well. I have yet been to a facility where it is expected for CNA's to do laundry. Maybe in home care, but not in a nursing home or hospital. And it's almost impossible to not wake somebody when repositioning them. You can try, but if that's your expectation, you're setting yourself up for failure.

The staffing problem can be managed if you are in good terms with other CNAs. As soon as you are debriefed by the outgoing nurse aide,try to sort out tasks starting with the most urgent. Do not hesitate to ask for assistance if the you need it. Since nursing patients is a team work, your colleagues will offer help if they are less burdened than you. If you are showing your concern for the comfort, safety and faster recovery of patients, getting help is easier.

At my previous facility, I would have to beg for help and this was because each CNA had over 15 total care patients. When I did ask for help, I was told I wasn't a good CNA and if I was I would know how to do A,B, and C. It's pretty hard to change a 400 pound sleeping, incontinent man on your own, but that was the expectation. You cannot ASSUME that you'll get help on night shift. At my hospital there are times when there is a single CNA for the floor for the entire shift. That could be up to 50 patients for 1 aide. Yes, the nurses try to help, but that's still 50 call lights you have to answer and 50 people you need to check on every 2 hours.

Since you have done your best to extend the lives of clients under your care, you should not be affected emotionally when the inevitable happens. When a patient dies, honor her or him by performing the after-death care. You may also need to console the relatives, and help them embrace the truth with a strong heart. Instead of lamenting over the fact, and take it to the heart, try communicating with co-workers. Get charged and make a promise to yourself that you will not allow any more death during your shift. This will motivate you to keep going.

Other people have already touched on this, but I will go on to say that what you suggest that aides do to "cope" is incredibly unhealthy and detrimental to the profession. Again, if you really believe you can just up and move on from a loved resident's death, you are setting your self up for failure, if you think you can keep somebody on this Earth for longer than God intends, then you need to have yourself a talk with Him. A CNA can do CPR and few other life saving techniques and CPR is effective what, 10% of the time? There are other measures a nurse can take, but that's an awful amount of responsibility being put on the aide here.

When patients are fast asleep, you will get enough time to handle these chores.
These are the challenges and tips to handle them while working in the night shift. If you manage your time and have planned properly, you can also have your breaks and chat with your co-workers in the spare time. No doubt, you will have problems working in night shift during the first few months. However, once you are accustomed to the routine, the shift will become enjoyable.

I don't know how long you've done night shift or where you work, but where I've worked, people DON'T sleep. And this is the issue night shifters have. Administration seems to think that people sleep throughout the night, and they just don't, then they understaff because of this expectation. When I was on night shift I can remember two occasions where I had the time to just sit and "chat" and I did plan properly and managed my time. I think your expectations for aides on night shift are just way too high, upsettingly so.

Thank you for your priceless inputs. You are also right to about the upset feelings when a person dies. However, sometimes attachments with patients never allow nursing aides to overcome the loss. I was trying to place my opinion about getting over the emotional feelings. You have also reminded nurse aides about their primary duty - to help patients die comfortably.

Yes! Not all patients sleep during the night. There are some who keep awake and need someone to talk to them. It is truly appreciating about you to know that you still managed some time, and planned your tasks accordingly.
Thank you for your thoughts.